These are the legal provisions related to hospital financial assistance/charity care in the state of New Jersey. This is intended for educational use and should not be treated as legal advice.
Is there a state charity care law?
Yes, New Jersey has its own law.
Qualifications for charity care in New Jersey
Does the law specify a minimum Federal Poverty Level (FPL) for charity care?
New Jersey's law regarding minimum FPL is as follows: Under state law, a patient is eligible for free care if they are at or below 200% FPL. They only have to pay 20% if they are between 200-225%, 40% if they are between 225-250%, 60% if they are between 250-275%, and 80% if they are between 275-300%.
Does the law specify a minimum deadline for applying for charity care?
New Jersey law specifies the minimum at 365 days from the first post-discharge bill.
Does the law specify that having insurance disqualifies a patient for charity care?
New Jersey law explicitly requires hospitals to provide assistance to the insured.
Does the law specify that patients must be residents to be eligible for charity care?
Under state law, a hospital only has to give charity care to New Jersey residents.
Does the law specify that patients must be US citizens or documented immigrants/lawful permanent residents to be eligible for charity care?
New Jersey law explicitly requires hospitals to provide assistance regardless of immigration status.
Does the law specify that patients must owe a minimum bill amount in order to be eligible for charity care?
New Jersey law does not address this matter, so federal law would apply.
Federal law says that non-profit hospitals may not require a minimum bill amount for a patient to qualify for charity care. All emergency and medically necessary care conducted at a non-profit hospital is eligible for charity care.
How the law applies to copays in New Jersey
Does the law specify that patients cannot be responsible for a copay if they are eligible for charity care?
New Jersey prohibits requiring a copay for emergency services.
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
New Jersey prohibits requiring a copay for emergency services.
Collections laws related to charity care in New Jersey
Does the law specify that hospitals cannot deny financial assistance to cover patient copays, coinsurance, or deductibles?
An individual can only be sent to collections for amounts not determiend eligible for charity care. A hospital must give an applicant a written notice that informs them about charity care, Medicaid, or NJ FamilyCare, or refer them to a medical assistance program within three months of the date of service. If they do not, then the hospital cannot pursue collections.
Length of time charity care can be applied to future bills in New Jersey
Does the law specify that hospitals must honor a charity care decision for future bills for a specific length of time?
New Jersey law does not address this matter, so federal law would apply.
Federal law does not directly address this. Nonprofit hospitals are simply required to follow their financial assistance policy.